Pelvis and Perineum Flashcards
Define the borders of the perineum: Anterior Posterior Anterolateral Lateral Posterolateral
Anterior: Pubic symphysis Posterior: Inferior sacrum and coccyx Anterolateral: Ischiopubic rami Lateral: Ischial tuberosities Posterolateral: Sacrotuberous ligaments
In the anatomical position:
- ) The anal triangle faces _______
- ) The urogenital triangle is oriented _______
- ) Posteroinferiorly
- ) Horizontally
- From slides, and p.244 BRS
The urogenital hiatus lies ______ in the urogenital triangle and allows passage of the _____ and ______.
Lies ANTERIORLY, and allows passage of the URETHRA and VAGINA
-Slides
What are the borders of the perineum
Anterior: Pubic symphysis Anterolateral: Ischiopubic rami Lateral: Ischial tuberosities Posterolateral: Sacrotuberous ligaments Posterior: Tip of coccyx -p.244 BRS
What two muscles make up the pelvic diaphragm (floor of the pelvis)?
Levator ani, coccygeus (ischiococcygeus)
What is the most anterior structure to pierce the pelvic diaphragm?
Urethra
What structure lies in between the urethra and the rectum? male and female
Pouch of Douglass (male), rectouterine pouch (female)
- ) What organs are said to be ABOVE the pelvic pain line?
2. ) What nerve fibers are associated with pain line (both above and below) and what carries them?
- ) Organs/portions of organs that are in contact with the peritoneum
- ) General visceral afferent fibers (pain fibers) are carried by the sympathetic nervous system. Below are carried by parasympathetic.
What artery supplies all of the external genitalia?
Internal pudendal
- ) ________ receives the deep dorsal vein of penis and vesical veins.
- ) The answer above drains into the _________.
- ) Prostatic venous plexus
- ) Internal iliac veins
* Please know, per Dr. Rich*
- ) In males, the ureter enters the bladder on the ______ aspect
- ) What structure crosses the ureter on the way to bladder
- ) Posterolateral
2. ) Ductus deferens
What gives sensory innervation to organs?
General visceral afferent: Sympathetic above pain line, parasympathetic below pain line.
Ureteric pain is usually referred to the ______ quadrant of the abdomen, especially to the _______.
IPSILATERAL LOWER QUADRANT, especially to the GROIN (inguinal region).
- ) Superior hypogastric plexus (sympathetic or parasympathetic) innervation?
- ) Pelvic splanchnics?
- ) Sympathetic
2. ) Parasympathetic
Bladder mucosa is thrown into rugae except within the ____ where it is smooth.
Trigone; near the urethral/bladder transition
What makes up the internal urethral sphincter
Circular fibers of the detrusal muscle at the neck of the bladder
List the structures that lie in relation to the following portions of the bladder:
- ) Superior (3)
- ) Inferolateral (5)
- ) Anterior (3)
- ) Peritoneum, ileum, sigmoid colon (PIS)
- ) Obturator internus, levator ani, obturator nerve, obturator artery and vein, superior vesical artery and vein
- ) Retropubic space - containing adipose tissue and veins, pubic crest
What structures lie (in relation to the bladder) 1.) posterior (4) and inferior (2) in males 2.) posterior (2), posterosuperior (2) in females.
1.) Posterior: Seminal vesicles, ampulla of ductus deferens, retrovesical pouch, ampulla of rectum. SAAD Pouch –> Sad Pouch
Inferior: Prostate, prostatic venous plexus
2.) Posterior: Cervix, anterior wall of vagina
Posterosuperior: Vesicouterine pouch, body of uterus
What arteries supply the follow portions of the bladder:
- ) Apex and superior part
- ) Fundus and neck (in males)
- ) Fundus and neck (in females)
- ) Superior vesicle arteries (branches of internal iliac)
- ) Inferior vesical arteries
- ) Vaginal arteries (branches of uterine arteries)
Define either sympathetic or para:
- ) Point (i.e. erection)
2. ) Shoot (i.e. ejac)
- ) Point = Parasympathetic
2. ) Shoot = Sympathetic
The sympathetic innervation that stimulates ejaculation simultaneously causes ________ to prevent reflux of semen into the bladder.
contraction of the internal urethral sphincter
Parasympathetic inhibition to the _______, and motor innervation to the _____ allows for urination.
- Internal urethral sphincter
- Detrusor muscle
Why is it easier for women to get UTIs?
Because of their comparitively short urethra (3-4cm)
List and describe the 3 parts of the male urethra and blood supply
- ) Prostatic urethra: Inferior vesical and rectal arteries.
- ) Membranous urethra (least dilatable part of urethra), travels through the external urethral sphincter. SHORTEST PORTION. Inferior vesical and rectal arteries
- ) Spongy urethra: Longest portion. Internal pudendal (all of external genitalia) artery via dorsal arteries of penis.